Download What is endometrial cancer?

National Centre for
Gynaecological Cancers
national centre for
gynaecological cancers
What is endometrial cancer?
Endometrial cancer is a cancer that arises from the lining
of the uterus (womb). The lining of the uterus is called the
endometrium.
Endometrial cancer is the most common type of cancer of the
uterus.
Important: There is a separate set of factsheets for the other
main type of cancer of the uterus, uterine sarcoma.
If you have been told you have ‘cancer of the uterus’, ‘cancer
of the womb’ or ‘uterine cancer’, and you are not sure if it
is endometrial cancer, check with a member of your
healthcare team.
The uterus
The lining of the uterus is called the endometrium. The
endometrium is made up of several layers, including skin-like
cells (surface epithelium), blood vessels, tissue spaces and
glands. If a woman is ovulating, the endometrium will grow
thicker each month to prepare for pregnancy. If the egg is not
fertilised, the top layers of the endometrium are shed and flow
out of the body through the vagina during menstruation. This
is known as a woman’s period.
Menopause occurs when a woman no longer releases
the hormones that cause ovulation and menstruation. A
menopausal woman’s monthly periods stop, and she is no
longer able to become pregnant. The uterus becomes smaller
and the endometrium becomes thinner and inactive.
The uterus, or womb, is the main female reproductive organ.
In women who are able to have children, the main function of
the uterus is to nourish a developing foetus.
What is cancer?
The uterus is about the size and shape of a hollow, upsidedown pear. The bulk of the uterus is smooth muscle tissue,
which is called the myometrium. The uterus sits low in the
abdomen between the bladder and rectum and is held there
lightly by muscle. It is joined to the vagina by the cervix, which
is the neck of the uterus.
Normally, cells grow and multiply in an orderly way.
When women ovulate, or produce eggs in their ovaries, an
egg travels through their fallopian tube into the uterus. If the
egg is fertilised by a sperm, it will implant itself into the lining
of the uterus and grow into a baby.
Cancer is a group of many related diseases. All cancers begin
in cells, the body’s basic building blocks.
In this factsheet:
The uterus
1
What is cancer? 1
Types of endometrial cancer
3
Staging and grading of endometrial cancer 3
Sources
3
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page 2
Ovary
Endometrium
(lining of the uterus)
Uterus
(womb)
Fallopian tube
Egg
Cervix
(neck of the uterus)
Ligaments
Myometrium
(smooth muscle of the uterus)
Vagina
(birth canal)
Vulva
The female reproductive system (internal)
However, damaged genes can cause them to behave
abnormally. They may grow into a lump called a tumour.
Tumours can be benign (not cancer) or malignant (cancer).
Benign conditions of the uterus (not cancer)
Fibroids are common benign tumours that grow in the
muscle of the uterus. They occur mainly in women in their
forties. Women may have many fibroids at the same time.
Fibroids do not develop into cancer. As a woman reaches
menopause, fibroids are likely to become smaller, and
sometimes they disappear.
Usually, fibroids cause no symptoms and need no treatment.
But depending on their size and location, fibroids can cause
bleeding, vaginal discharge, and frequent urination. Women
with these symptoms should see a doctor. If fibroids cause
heavy bleeding, or if they press against nearby organs
and cause pain, the doctor may suggest surgery or other
treatment.
Endometriosis is another benign condition that affects the
uterus. It is most common in women in their thirties and
forties, especially in women who have never been pregnant. It
occurs when endometrial tissue begins to grow on the outside
of the uterus and on nearby organs. This condition may cause
painful menstrual periods, abnormal vaginal bleeding, and
sometimes loss of fertility (ability to get pregnant), but it does
not cause cancer. Women with endometriosis may be treated
with hormones or surgery.
Endometrial hyperplasia is an increase in the number of
cells in the lining of the uterus. It is not cancer. Sometimes
it develops into cancer. Heavy menstrual periods, bleeding
between periods, and bleeding after menopause are common
symptoms of hyperplasia. It is most common after age 40.
To prevent endometrial hyperplasia from developing into
cancer, the doctor may recommend surgery to remove
the uterus (hysterectomy) or treatment with hormones
(progesterone) and regular follow-up exams.
Malignant tumours (cancer)
A malignant tumour is made up of cancer cells. If these
cells are not treated, they may spread beyond their normal
boundaries and into surrounding tissues, becoming invasive
cancer. This spread of cancer is called metastasis.
When cancer spreads from its original place to another part of
the body, the new tumour has the same kind of abnormal cells
and the same name as the primary tumour.
When endometrial cancer spreads (metastasises) outside the
uterus, cancer cells are often found in nearby lymph nodes,
nerves, or blood vessels. If the cancer has reached the lymph
nodes, cancer cells may have spread to other lymph nodes
and other organs, such as the lungs, liver, and bones.
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For more information about cancer and how it spreads, see
our factsheet What is cancer?
Types of endometrial cancer
Most endometrial cancers are adenocarcinomas (cancers that
begin in the glandular cells, which make and release mucus
and other fluids).
The other types of endometrial cancers include
adenosquamous carcinoma, serous carcinoma and clear cell
carcinoma. These types of cancer grow more rapidly and are
typically more aggressive than adenocarcinoma.
Staging and grading of endometrial cancer
The stage of a cancer is a term used to describe its size and
whether it has spread beyond its original area of the body.
The grade of a cancer describes how quickly the tumour is
likely to grow.
• Stage 3: The cancer has spread beyond the uterus/
cervix to the ovaries, fallopian tubes, vagina or nearby
lymph nodes.
• Stage 4: The cancer has spread further, to the inside
of the bladder or rectum, throughout the abdomen or
to other body parts.
• Recurrent: If the cancer comes back after initial
treatment, this is known as recurrent cancer.
Endometrial cancer may come back in the uterus or in
another part of the body.
Grading
A pathologist will use tests on your cancer biopsy to ‘grade’ your
cancer. Grade refers to the extent of similarity of cancer cells to
normal cells. Low-grade tumours tend to grow more slowly while
high-grade tumours grow faster and spread more quickly.
Sources
Knowing the extent of the cancer and the grade helps the
doctors to decide on the most appropriate treatment.
We thank the following organisations for allowing their
information to be used for this factsheet:
Staging
The staging system used for cancer of the uterus is the
FIGO system, developed by the International Federation for
Gynecology and Obstetrics. The staging system is based on
the spread of the cancer:
Cancer Council New South Wales
www.cancercouncil.com.au
National Cancer Institute (USA)
www.cancer.gov
• Stage 1: The cancer is confined to the uterus.
• Stage 2: The cancer has spread to the cervix.
NATIONAL CENTRE FOR GYNAECOLOGICAL CANCERS
CANCER AUSTRALIA
ABN 21075951918
The National Centre for Gynaecological Cancers is an Australian Government initiative to improve outcomes for women affected by
gynaecological cancers, their families and carers, and to lessen the impact of cancer on their lives. It has been established by Cancer Australia.
What is endometrial cancer? 2010
Last updated 2009. The information in this fact sheet was current at the time of publication. To check if it is the most up-to date version, please call 02 6217 9818
Disclaimer: This information is presented by Cancer Australia for the purpose of disseminating information free of charge to the public. It should not be used
for therapeutic purposes or as a substitute for your own health professional’s advice. Cancer Australia does not accept any liability for any injury, loss or damage
incurred by use of or reliance on the information provided on this website.
National Centre for Gynaecological Cancers, Cancer Australia, PO Box 1201, Dickson ACT 2602
Tel: 02 6217 9818 | Email: [email protected]
www.gynaecancercentre.gov.au